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目的:通过孕产妇死亡评审了解孕产妇主要死因及相关影响因素,提出降低孕产妇死亡率的干预措施。方法:对毕节市2004-2011年孕产妇死亡报告卡、个案调查表、分析报告和评审结果进行回顾性分析。结果:2004-2011年毕节市孕产妇死亡率呈下降趋势。孕产妇死亡原因顺位依次为产科出血、羊水栓塞、妊娠期高血压疾病、产褥感染。产科出血占59.36%,前3位原因分别为胎盘因素、宫缩乏力、子宫破裂。孕产妇死亡与其文化程度、家庭经济收入、孕产期保健服务等因素有关。目前,孕产妇死亡率的主要影响因素是各级医疗保健机构尤其是县级医疗保健机构的知识技能问题。结论:降低孕产妇死亡率的主要措施包括争取政策支持和保证,提高各级领导及相关部门对孕产妇安全工作的重视,加强妇幼保健三级网络建设,强化妇幼保健管理,加强对助产机构的监管,改善医疗条件,提高产科质量,加强健康教育及孕期保健知识宣传,提高妇女自我保健意识。
OBJECTIVE: To understand the main causes of maternal death and the related influencing factors through assessment of maternal death and propose interventions to reduce the maternal mortality rate. Methods: A retrospective analysis was carried out on the report card of maternal death, case investigation form, analysis report and review result of 2004-2011 in Bijie City. Results: The maternal mortality rate in Bijie City dropped from 2004 to 2011. The order of maternal death followed by obstetric bleeding, amniotic fluid embolism, gestational hypertension, puerperal infection. Obstetric bleeding accounted for 59.36%, the first three reasons were placental factors, uterine atony, uterine rupture. Maternal deaths are related to their educational level, family income, and maternal health services. At present, the main influencing factor of maternal mortality is the knowledge and skills of health care institutions at all levels, especially the county-level healthcare institutions. Conclusion: The main measures to reduce the maternal mortality rate include obtaining policy support and guarantee, increasing the attention of leaders and relevant departments at all levels on the work of maternal safety, strengthening the construction of a three-level maternal and child health network, strengthening the management of maternal and child health, Improve the medical conditions, improve the quality of obstetrics, strengthen health education and publicity on health care during pregnancy, and raise the awareness of women’s self-care.